Effects of Exercise-Based Cardiac Rehabilitation on Patients Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis
DOI:
https://doi.org/10.59958/hsf.7287Keywords:
exercise, cardiac rehabilitation, percutaneous coronary intervention, coronary heart disease, systematic review, meta-analysisAbstract
Objective: This study aims to systematically analyze the impact of exercise-based cardiac rehabilitation on patients undergoing percutaneous coronary intervention (PCI). Methods: We searched for original studies on the effect of exercise-based cardiac rehabilitation on patients undergoing PCI published in domestic and foreign databases such as PubMed, Web of Science, Embase, Cochrane Library, China Knowledge Network (CNKI), and VIP until December 2023. Studies retrieved were screened, and meta-analysis was extracted. The quality of the literature was evaluated; meta-analysis was carried out by RevMan5.4 software (Cochrane Collaboration, Oxford, UK). Results: A total of 1073 sufferers undergoing PCI were included in 11 literatures. Meta-analysis displayed that cardiogenic mortality [risk ratio (RR) = 0.23, 95% confidence interval (CI) (0.08, 0.64)], coronary restenosis rate [RR = 0.59, 95% CI (0.41, 0.87)], revascularization rate [RR = 0.58, 95% CI (0.43, 0.79)], incidence of recurrent angina pectoris [RR = 0.41, 95% CI (0.27, 0.62)], and late lumen loss [RR = –0.60, 95% CI (–0.98, –0.23)] in the trial group, were lower than those in the control group (p < 0.05). No significant difference was found in the recurrence rate of myocardial infarction between the test group and the control group [RR = 0.52, 95% CI (0.22, 1.25)]. Conclusion: Exercise-based cardiac rehabilitation therapy can effectively reduce the risk of major adverse cardio-cerebrovascular events, such as cardiogenic death and coronary restenosis after PCI; it reduces the late lumen loss of the stent coronary segment and has no obvious effect on the recurrence of myocardial infarction. However, this therapy tends to reduce the recurrence rate of myocardial infarction.
References
Katta N, Loethen T, Lavie CJ, Alpert MA. Obesity and Coronary Heart Disease: Epidemiology, Pathology, and Coronary Artery Imaging. Current Problems in Cardiology. 2021; 46: 100655.
Chen M, Liu M, Guo X, Zhou J, Yang H, Zhong G, et al. Effects of Xinkeshu tablets on coronary heart disease patients combined with anxiety and depression symptoms after percutaneous coronary intervention: A meta-analysis. Phytomedicine. 2022; 104: 154243.
Hannan EL, Zhong Y, Cozzens K, Jacobs AK, King SB, 3rd, Tamis-Holland J, et al. Ad Hoc Percutaneous Coronary Intervention in Stable Patients With Multivessel or Unprotected Left Main Disease. JACC. Cardiovascular Interventions. 2023; 16: 1733–1742.
Holm NR, Mäkikallio T, Lindsay MM, Spence MS, Erglis A, Menown IBA, et al. Percutaneous coronary angioplasty versus coronary artery bypass grafting in the treatment of unprotected left main stenosis: updated 5-year outcomes from the randomised, non-inferiority NOBLE trial. Lancet. 2020; 395: 191–199.
Chen M, Ma F, Su B, Wang C, Zheng Q, Zhang Y, et al. Treatment effect of metformin combined with atorvastatin in reducing in-stent restenosis after percutaneous coronary intervention in coronary artery disease patients with type 2 diabetic patients. Medicine. 2022; 101: e31107.
Takeuchi M, Dohi T, Fukase T, Nishio R, Takahashi N, Endo H, et al. Comparison of clinical outcomes between percutaneous coronary intervention for de novo lesions versus in-stent restenosis lesions. Cardiovascular Intervention and Therapeutics. 2022; 37: 324–332.
Xu L, Xiong W, Li J, Shi H, Shen M, Zhang X, et al. Role of the intelligent exercise rehabilitation management system on adherence of cardiac rehabilitation in patients with coronary heart disease: a randomised controlled crossover study protocol. BMJ Open. 2020; 10: e036720.
Zhang H, Chang R. Effects of Exercise after Percutaneous Coronary Intervention on Cardiac Function and Cardiovascular Adverse Events in Patients with Coronary Heart Disease: Systematic Review and Meta-Analysis. Journal of Sports Science & Medicine. 2019; 18: 213–222.
Wu XH, Li GQ, Zhan CX, Mao XQ, Su YY. Effect of Rehabilitation Therapy on Cardiovascular Events and Quality of Life in Patients with Coronary Heart Disease undergoing PCI. China Health Care & Nutrition. 2013; 9: 92–93. (In Chinese)
Hofman-Bang C, Lisspers J, Nordlander R, Nygren A, Sundin O, Ohman A, et al. Two-year results of a controlled study of residential rehabilitation for patients treated with percutaneous transluminal coronary angioplasty. A randomized study of a multifactorial programme. European Heart Journal. 1999; 20: 1465–1474.
Liu ZH. Clinical evaluation of real-time exercise therapy on prognosis of patients with coronary heart disease after PCI. Chinese Journal of Gerontology. 2015; 5765–5766. (In Chinese)
Belardinelli R, Paolini I, Cianci G, Piva R, Georgiou D, Purcaro A. Exercise training intervention after coronary angioplasty: the ETICA trial. Journal of the American College of Cardiology. 2001; 37: 1891–1900.
Cui F, Ren YS, Wang HF, Li L, Mou L, Ma H. Effect of rehabilitation training on exercise tolerance of patients with coronary heart disease after interventional therapy. Chinese Journal of Physical Medicine and Rehabilitation. 2006; 177–179. (In Chinese)
Mei J, Guo XP, Sun JA, Qi SY, Yang L, Ru LS. Effects of Early Exercise Prescription on Myocardial Infarction Patients’ Rehabilitation and Restenosis after Stent Implantation plus Percutaneous Transluminal Coronary Angioplasty. Nursing Journal of Chinese PLA. 2009; 26: 11–13. (In Chinese)
Niu F, Wang JY. Effect of exercise rehabilitation on patient’s cardio-function and major adverse cardiac vascular events after percutaneous coronary intervention. Practical Journal of Medicine & Pharmacy. 2017; 34: 110–112. (In Chinese)
Hansen D, Dendale P, Leenders M, Berger J, Raskin A, Vaes J, et al. Reduction of cardiovascular event rate: different effects of cardiac rehabilitation in CABG and PCI patients. Acta Cardiologica. 2009; 64: 639–644.
Dendale P, Berger J, Hansen D, Vaes J, Benit E, Weymans M. Cardiac rehabilitation reduces the rate of major adverse cardiac events after percutaneous coronary intervention. European Journal of Cardiovascular Nursing. 2005; 4: 113–116.
Lee HY, Kim JH, Kim BO, Byun YS, Cho S, Goh CW, et al. Regular exercise training reduces coronary restenosis after percutaneous coronary intervention in patients with acute myocardial infarction. International Journal of Cardiology. 2013; 167: 2617–2622.
Munk PS, Staal EM, Butt N, Isaksen K, Larsen AI. High-intensity interval training may reduce in-stent restenosis following percutaneous coronary intervention with stent implantation A randomized controlled trial evaluating the relationship to endothelial function and inflammation. American Heart Journal. 2009; 158: 734–741.
Liu X, Zhou W, Fan W, Li A, Pang J, Chen Z, et al. The benefit of exercise rehabilitation guided by 6-minute walk test on lipoprotein-associated phospholipase A2 in patients with coronary heart disease undergoing percutaneous coronary intervention: a prospective randomized controlled study. BMC Cardiovascular Disorders. 2022; 22: 177.
Zabojszcz M, Januszek R, Siudak Z, Janion-Sadowska A, Jędrychowska M, Pawlik A, et al. Association between the mortality rate and operator volume in patients undergoing emergency or elective percutaneous coronary interventions. Kardiologia Polska. 2020; 78: 138–146.
Elsayegh AT, Karim K, Shabana A. Impact of Cardiac Rehabilitation Programs Post Primary Percutaneous Coronary Intervention on Functional Capacity and Metabolic Profile Through Different Age Groups. High Blood Pressure & Cardiovascular Prevention. 2023; 30: 145–150.
McCallum CJ, Stewart K, MacIntyre PD. The illness perceptions of patients with percutaneous coronary intervention compared to patients with no percutaneous intervention, for acute myocardial infarction, in cardiac rehabilitation. Coronary Artery Disease. 2023; 34: 496–503.
Yao X, Jin Y, Gao C, Zhang Y, Lu Y, Li X, et al. Phase I cardiac rehabilitation with 5-phase music after emergency percutaneous coronary intervention for acute myocardial infarction: A prospective randomized study. Medicine. 2023; 102: e33183.
Fu C, Wang H, Wei Q, He C, Zhang C. Effects of rehabilitation exercise on coronary artery after percutaneous coronary intervention in patients with coronary heart disease: a systematic review and meta-analysis. Disability and Rehabilitation. 2019; 41: 2881–2887.
Tamulevičiūtė-Prascienė E, Beigienė A, Thompson MJ, Balnė K, Kubilius R, Bjarnason-Wehrens B. The impact of additional resistance and balance training in exercise-based cardiac rehabilitation in older patients after valve surgery or intervention: randomized control trial. BMC Geriatrics. 2021; 21: 23.
Osailan A, Abdelbasset WK. Exercise-based cardiac rehabilitation for postcoronary artery bypass grafting and its effect on hemodynamic responses and functional capacity evaluated using the Incremental Shuttle Walking Test: A retrospective pilot analysis. Journal of the Saudi Heart Association. 2020; 32: 25–33.
Misumi K, Nakanishi M, Miura H, Date A, Tokeshi T, Kumasaka L, et al. Exercise-Based Cardiac Rehabilitation Improves Exercise Capacity Regardless of the Response to Cardiac Resynchronization Therapy in Patients With Heart Failure and Reduced Ejection Fraction. Circulation Journal. 2021; 86: 49–57.
Dibben G, Faulkner J, Oldridge N, Rees K, Thompson DR, Zwisler AD, et al. Exercise-based cardiac rehabilitation for coronary heart disease. The Cochrane Database of Systematic Reviews. 2021; 11: CD001800.
